CMS Formulary

Displaying 141821-141830 of 1611142 results.
ID: 141821
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141822
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141823
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141824
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141825
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141826
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141827
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141828
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141829
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 620
Qty Limit Days: 31
ID: 141830
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31